Insulin Resistance Is Central to Long-Term Reversal of Histologic Nonalcoholic Steatohepatitis After Metabolic Surgery

Abstract Context Nonalcoholic steatohepatitis (NASH) is considered the hepatic counterpart of metabolic syndrome. Objective This work aimed to investigate the determinants of NASH reversal in patients undergoing biliopancreatic diversion (BPD) in a 5-year follow-up study. Methods This prospective st...

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Published in:The journal of clinical endocrinology and metabolism 2021-03, Vol.106 (3), p.750-761
Main Authors: Russo, Maria Francesca, Lembo, Erminia, Mari, Andrea, Angelini, Giulia, Verrastro, Ornella, Nanni, Giuseppe, Pompili, Maurizio, Raffaelli, Marco, Vecchio, Fabio Maria, Bornstein, Stefan R, Mingrone, Geltrude
Format: Article
Language:English
Subjects:
Biopsy
Body mass index
Cholesterol
Comparative analysis
Ethylenediaminetetraacetic acid
Fatty liver
Fibrosis
Gastrointestinal surgery
High density lipoprotein
Homeostasis
Insulin resistance
Liver
Low density lipoproteins
Metabolic syndrome
Metabolism
Neural networks
Obesity
Patients
Remission
Surgery
Triglycerides
Type 2 diabetes
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Summary:Abstract Context Nonalcoholic steatohepatitis (NASH) is considered the hepatic counterpart of metabolic syndrome. Objective This work aimed to investigate the determinants of NASH reversal in patients undergoing biliopancreatic diversion (BPD) in a 5-year follow-up study. Methods This prospective study was conducted at Policlinico Universitario Agostino Gemelli. A total of 37 patients underwent fine-needle liver biopsy during BPD. Ultrasonography-guided percutaneous liver biopsy was obtained 5 years after the operation. The primary outcome of our study was histologic NASH reversal at 5-year follow-up. To better characterize the clinical variables involved in the resolution of NASH, we also compared patients without histologic NASH resolution at 5 years with those in whom NASH had disappeared. Results At follow-up, NASH had reversed in 56.5% of the patients. The NAFLD activity score (NAS) improved from 3.7 ± 0.93 to 2 ± 1.11 (P 
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgaa892